Empagliflozin treatment can reduce extracellular volume (ECV) and lead to reverse extracellular matrix (ECM) remodeling in patients with type 2 diabetes (T2D) and coronary artery disease (CAD), according to a new study published in JACC: Cardiovascular Imaging.
The authors used cardiac MR (CMR) imaging findings to track the left ventricular ECV of 39 patients who received empagliflozin for six months and another 35 patients who received a placebo.
After the six months, the CMR data showed that patients in the empagliflozin group had reduced ECV compared to those in the placebo group. Patients taking empagliflozin also had reduced indexed extracellular compartment volume (iECV) and there was “a trend toward reduction” in indexed intracellular compartment volume (iICV).
However, there was no difference in soluble suppressor of tumorgenicity (sST2) or matrix metalloproteinase-2 (MMP-2) between the two patient groups.
These findings, the authors explained, show that the impact of treatment with SGLT2 inhibitors can go beyond just lowering the patient’s glucose.
“This is the first study to demonstrate that in patients with T2D and CAD, empagliflozin, in addition to standard of care management including renin-angiotensin system blockers, favorably reduced myocardial ECV as measured by CMR over a six-month period,” wrote lead author Tamique Mason, MSc, of the University of Toronto, and colleagues. “Our results suggest that further studies evaluating the mechanism by which ECV was reduced should be pursued.”
The full analysis is available here.